eligibility_summary
Inclusion: immunocompetent primary CNS DLBCL, age >=70 or 65–70 unfit for intensive therapy, CNS-only measurable disease, pathology-confirmed B-cell lymphoma, ECOG <=2 (PCNSL-related exceptions), consent. Randomization: ASCT-eligible (EBL/MD), no progression post prephase. Exclude: immunodef/HIV/transplant, systemic lymphoma or isolated VR/LM disease, prior NHL/other recent cancer, CrCl<60 or major organ dysfunction, active HBV/HCV, poor compliance or inability/refusal of consent/contraception.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Randomized phase III in elderly PCNSL (DLBCL) comparing: (A) R-MP (rituximab + high-dose methotrexate + procarbazine) with procarbazine maintenance vs (B) short induction MARTA (rituximab + high-dose methotrexate + cytarabine) followed by age-adjusted high-dose chemotherapy (busulfan, thiotepa) and autologous stem cell transplant. Drug types/mechanisms: Rituximab is an anti-CD20 monoclonal antibody depleting B cells via complement/ADCC/apoptosis. Methotrexate is an antifolate antimetabolite inhibiting DHFR/thymidylate synthesis. Cytarabine is a nucleoside analog blocking DNA polymerase (S phase). Procarbazine, busulfan, thiotepa are DNA-alkylating/cross-linking agents, busulfan/thiotepa are myeloablative for conditioning. Targets/pathways: CD20+ malignant B cells in CNS, folate metabolism and thymidylate pathways, DNA replication/repair, hematopoietic ablation with ASCT rescue.